Active NPI
Acadiana Surgical Clinic Inc
- Surgery Physician
- Opelousas, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- ACADIANA SURGICAL CLINIC INC
- Practice address
- 3975 I 49 S Service Rd
Suite 105
Opelousas, LA 70570-0775 - Phone
- (337) 948-7680
- Fax
- (337) 948-1143
- NPI assigned
- Nov 1, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Glynn A. Granger, MD
- Title
- Owner/MD
- Phone
- (337) 948-7680
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | Primary |
Addresses
Primary practice location
3975 I 49 S Service Rd
Suite 105
Opelousas, LA 70570-0775
Mailing address
3975 I 49 S Service Rd
Suite 105
Opelousas, LA 70570-0775
Phone (337) 948-7680
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CN6611 | Other | LA | RAILROAD MEDICARE |
| 1457221 | Medicaid | LA |
National Provider Directory
National Provider DirectoryLocations
3975 I 49 N Service Rd
Ste 104
Opelousas, LA 70570
Phone (337) 948-7680
3975 I 49 S Service Rd
Ste 105
Opelousas, LA 70570
Phone (337) 597-0750
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130803200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1320796800000",
"number": "1821089665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3975 I 49 S SERVICE RD",
"address_2": "SUITE 105",
"city": "OPELOUSAS",
"state": "LA",
"postal_code": "705700775",
"telephone_number": "337-948-7680",
"fax_number": "337-948-1143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3975 I 49 S SERVICE RD",
"address_2": "SUITE 105",
"city": "OPELOUSAS",
"state": "LA",
"postal_code": "705700775",
"telephone_number": "337-948-7680",
"fax_number": "337-948-1143"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ACADIANA SURGICAL CLINIC INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-01",
"last_updated": "2011-11-09",
"status": "A",
"authorized_official_last_name": "GRANGER",
"authorized_official_first_name": "GLYNN",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "OWNER/MD",
"authorized_official_telephone_number": "337-948-7680",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CN6611",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1457221",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Opelousas, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.